LA CLINICA- LATINO COMMUNITY HEALTH CENTERS
Ambulatory Health at Fairview Ave, Saint Louis, MO

License number
Missouri 18643752
Category
Ambulatory Health
Type
Health Service
Owner
Name: DR. WILLIAM CHIGNOLI M.D.
Title: FOUNDER AND C.E.O.
Phone: (314) 352-7400
Address
Address
3646 Fairview Ave, Saint Louis, MO 63116
National Provider ID: 1649278896
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LA CLINICA- LATINO COMMUNITY HEALTH CENTERS

3646 Fairview Ave, Saint Louis, MO 63116

Status:
Inactive
Registration:
Feb 20, 2003
State ID:
N00071346
Business type:
Nonprofit Corporation
Expiration:
Perpetual
Agent:
Mary Ann Cook,750 S Hanley Rd #52, Saint Louis, MO 63105 (Physical)

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